Patients with a weakened immune system due to immunosuppressive therapies can develop good immune responses to a corona vaccination. A third dose of vaccine may be necessary for those patients who do not produce antibodies. This is shown by a current study by MedUni Vienna.
People affected by autoimmune diseases often need therapy that weakens the immune system. It is precisely in this group that COVID-19 can develop severely. Up until now it was unclear whether a vaccination against SARS-CoV-2 would guarantee a sufficient response, especially in patients who are receiving so-called B-cell-depleting drugs (e.g. rituximab for rheumatoid arthritis). In a recently published study by a cross-departmental team from the Medical University of Vienna coordinated by the Clinical Department for Rheumatology (Head: Daniel Aletaha) of the University Clinic for Internal Medicine III, this question has now been answered. Senior author Michael Bonelli and his study team were able to show that the majority of these patients are still able to develop a humoral and cellular immune response.
Michael Bonelli says: “B cells represent an important cell population for the development of antibodies. We were able to show that patients under B-cell-depleting therapy with rituximab still develop antibodies against SARS-CoV-2 in more than 50% of cases there is possible additional protection through a cellular immune response. This underlines the importance of vaccinating immunosuppressed patients against SARS-CoV-2. “
Sometimes a third vaccination is needed
Daniel Aletaha, Head of the Clinical Department for Rheumatology, explains further: “The findings of this work formed the basis for a now completed randomized booster vaccination study in which we examined whether that group of patients under therapy with rituximab were after Standard vaccination could not produce antibodies, but a third vaccination with a new mRNA vaccine or a switch to vector vaccine still developed humoral or cellular immunity. The results of the first vaccination study are about to be published and will hopefully contribute to the creation of guidelines for the vaccination strategy against SARS-CoV-2 in immunosuppressed patients.”
A follow-on study of the same design, for which volunteers are currently being recruited, will now extend the rituximab study to all patients with immunosuppression and different indications from the fields of rheumatology, neurology, hematology, transplantation, and others. This project is a collaboration between many researchers from different divisions/institutes of MedUni Vienna.
Service: Annals of the Rheumatic Diseases
SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity. Mrak D, Tobudic S, Koblischke M, Graninger M, Radner H, Sieghart D, Hofer P, Perkmann T, Haslacher H, Thalhammer R, Winkler S, Blüml S, Stiasny K, Aberle JH, Smolen JS, Heinz LX, Aletaha D , Bonelli M. Ann Rheum Dis. 2021 Jul 20: annrheumdis-2021-220781. doi: 10.1136 / annrheumdis-2021-220781.
Provided by Medical University of Vienna